Turkish Neurosurgery 2023 , Vol 33 , Num 6
Surgery in Intracerebral Arteriovenous Malformations: The Role of Preoperative Embolization
Mahmut OZDEN1,Koral ERDOGAN1,Melih BOZKURT1
1Private Memorial Hospital, Department of Neurosurgery, Bahcelievler, Istanbul, Turkey
2Gelisim University, College of Health Sciences, Istanbul, Turkey
3Arel University, Faculty of Medicine, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.44032-23.2 AIM: To examine the outcomes of microsurgery only versus combined microsurgery and embolization in treating cerebral arteriovenous malformations (AVM).

MATERIAL and METHODS: A total of 62 patients (34 male and 28 female) with Spetzler?Martin grade 3 (n=44) and grade 4 (n=18) AVMs were examined. Thirty-seven patients were treated with a combination of microsurgery + embolization, whereas 25 patients were treated with microsurgery alone. The clinical characteristics of the treatment groups were compared (ruptured/unruptured, eloquent/non-eloquent, modified Rankin scores, duration of surgery, preoperative and postoperative hemoglobin levels, and use of blood products).

RESULTS: The number of patients with ruptured or eloquently localized AVMs was more in combination of microsurgery + embolization. On the other hand, the duration, preoperative versus postoperative hemoglobin levels, and usage of blood products did not differ between treatment groups.

CONCLUSION: The results of the study showed no superiority of the combined treatment in managing AVMs in parallel to recent meta-analyses. However, a patient-tailored approach is recommended while making the treatment decision for such challenging intracerebral AVM cases. Keywords : Arteriovenous malformation, Intracerebral, Embolization, Microsurgery

Corresponding author : Melih BOZKURT, melihbozkurt@hotmail.com